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Institution

Ochsner Medical Center

HealthcareNew Orleans, Louisiana, United States
About: Ochsner Medical Center is a healthcare organization based out in New Orleans, Louisiana, United States. It is known for research contribution in the topics: Population & Heart failure. The organization has 980 authors who have published 1159 publications receiving 49961 citations. The organization is also known as: Ochsner Hospital & Ochsner Foundation Hospital.


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Journal ArticleDOI
TL;DR: The severity index (SI) is described as a simple method that can be used in the identification of low-dysplastic developmental spondylolisthesis from HDDS allowing earlier surgical stabilization to prevent slip progression and to provide guidelines for using the unstable zone for the inclusion of L4 in stabilization.
Abstract: The classification system of spondylolisthesis proposed by Marchetti and Bartolozzi is the most practical regarding prognosis and treatment and includes the description of both low- and high-dysplastic developmental spondylolisthesis (HDDS). Unfortunately, it does not provide strict criteria on how to differentiate between these two subtypes. The accepted treatment for HDDS is surgical. However, there is no consensus on how to surgically stabilize this subtype of spondylolisthesis, and although the concept of reducing spinal deformity before fusion is attractive, the issue of surgical reduction versus in situ fusion remains controversial, especially for HDDS (Meyerding Grades III and IV). The purpose of this study was (1) to describe the severity index (SI) as a simple method that can be used in the identification of low-dysplastic developmental spondylolisthesis from HDDS allowing earlier surgical stabilization to prevent slip progression, (2) to provide guidelines for using the unstable zone for the inclusion of L4 in stabilization, and (3) to describe a surgical technique in the reduction and stabilization of this challenging surgical entity in an attempt to decrease the risk of iatrogenic L5 neurologic injury. The concepts of SI and unstable zone in the evaluation and treatment of HDDS are relatively new. In our study, patients with an SI value >20% were classified as having HDDS and surgical stabilization was offered. In addition, all vertebrae that were contained in the defined unstable zone were surgically instrumented and fused with attempts at anatomic reduction. This case series involved the retrospective radiological review of 25 consecutive patients surgically treated for HDDS between April 2000 and September 2004 by two senior surgeons. All 25 patients had a minimum 3-year follow-up. Reduction of slip, lumbosacral kyphosis, sacral inclination, fusion rate, maintenance of reduction, and iatrogenic L5 neurologic injury were evaluated. Twenty-two patients underwent a single-level L5–S1 fusion. Three patients had extension of the L5–S1 fusion to include L4 because it fell into the unstable zone. Slip improved from 67.2 to 13.6%, focal L5–S1 kyphosis improved from +17.5° to −6.4°. There were no pseudoarthroses and all patients had radiographic evidence of solid bony fusion at latest follow-up. To date, there have been no re-operations secondary to progression of deformity or loss of fixation. Two re-operations were performed, one for a superficial wound infection, the other for further laparoscopic decompression for continued L5 nerve root symptoms after the index surgery. One patient developed an iatrogenic L5 radiculopathy with dysaesthesiae 3 days postoperatively which completely resolved over 6 weeks. HDDS is best treated surgically. Early identification and stabilization of this challenging surgical entity could prevent the progression of slip and deformity making the index surgery less technically demanding. Vertebrae that are contained in the unstable zone can be instrumented and stabilized so that progression of the deformity and re-operation might be avoided. The authors suggested surgical technique can provide a way to restore sagittal balance, provide an environment for successful fusion, and decrease the risk of iatrogenic L5 neurologic injury.

76 citations

Journal ArticleDOI
TL;DR: The ability of cardiac rehabilitation and exercise training programs to improve exercise capacity, plasma lipid values, obesity indices, behavioral characteristics, and quality of life parameters in a large cohort of patients who have had major CAD events is supported.
Abstract: Previous studies have indicated the benefits of cardiac rehabilitation programs after major coronary artery disease (CAD) events. We studied 591 consecutive patients from two academic institutions before and after completion of a cardiac rehabilitation and exercise training program to determine the effects of this therapy on exercise capacity, indices of obesity, plasma lipid values, behavioral characteristics, and quality of life parameters. After cardiac rehabilitation, statistically significant improvements occurred in exercise capacity (+33%), percent body fat (-6%), body mass index (-1%), HDL-C (+5%), triglycerides (-9%), LDL-C/HDL-C (-6%), anxiety score (-39%), depression score (-35%), somatization score (-37%), and in all parameters of quality of life studied (total +14%). These data further support the ability of cardiac rehabilitation and exercise training programs to improve exercise capacity, plasma lipid values, obesity indices, behavioral characteristics, and quality of life parameters in a large cohort of patients who have had major CAD events.

75 citations

Journal ArticleDOI
TL;DR: Two classes of compounds have been developed that can directly activate sGC and increase cGMP formation in pathophysiologic conditions when NO formation and bioavailability are impaired or when NO tolerance has developed.
Abstract: The heme-protein soluble guanylyl cyclase (sGC) is the intracellular receptor for nitric oxide (NO). sGC is a heterodimeric enzyme with α and β subunits and contains a heme moiety essential for binding of NO and activation of the enzyme. Stimulation of sGC mediates physiologic responses including smooth muscle relaxation, inhibition of inflammation, and thrombosis. In pathophysiologic states, NO formation and bioavailability can be impaired by oxidative stress and that tolerance to NO donors develops with continuous use. Two classes of compounds have been developed that can directly activate sGC and increase cGMP formation in pathophysiologic conditions when NO formation and bioavailability are impaired or when NO tolerance has developed. In this report, we review current information on the pharmacology of heme-dependent stimulators and heme-independent activators of sGC in animal and in early clinical studies and the potential role these compounds may have in the management of cardiovascular disease.

75 citations


Authors

Showing all 993 results

NameH-indexPapersCitations
Carl J. Lavie106113549318
Michael R. Jaff8244228891
Michael F. O'Rourke8145135355
Mandeep R. Mehra8064431939
Richard V. Milani8045423410
Christopher J. White7762125767
Bruce A. Reitz7433318457
Robert C. Bourge6927324397
Sana M. Al-Khatib6937717370
Hector O. Ventura6647816379
Andrew Mason6336015198
Aaron S. Dumont6038613020
Philip J. Kadowitz5537911951
David W. Dunn541958999
Lydia A. Bazzano5126713581
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20231
202223
2021120
2020117
2019102
201886